Part B claims processed on and after February 10, 2020, will be edited for positron emission tomography (PET) scan and tracer codes and will reject if a tracer code is not billed for the same date of service with a PET scan code and vice versa. [CR 10319]
The Centers for Medicare & Medicaid Services (CMS) recently issued the 2019 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. [MM11025]
Submitted in response to a common billing issue relating to improper or insufficient documentation for tetanus vaccinations. Data indicates that many providers are not submitting proper diagnosis codes to support the medical necessity for tetanus vaccinations.
First Coast would like to ensure providers performing biopsy services understand how to properly bill and code for these procedures. Recent data indicates improper billing so we want to provide clarification of top issues we identified.
The interest period begins on the day after payment is due and ends on the day of payment. The new rate of 2.125 percent is in effect January through June 2020. [Publication 100-04, Chapter 1, Section 80.2.2]
Learn which modifier to use when you expect Medicare will deny a claim that does not meet medical necessity criteria and whether you have or do not have an advanced beneficiary notice (ABN) signed by the beneficiary.
The Multi-Carrier System (MCS) currently requires modifiers 59, XE, XS, XP, and XU be appended to the column two code to bypass a procedure-to-procedure (PTP) edit. Effective July 1, 2019, Medicare will allow these modifiers on column one and column two codes to bypass the edit. More information is available in MLN Matters® article MM11168 linked here. [MM11168]
Most services billed to Medicare must reflect the exact date the service was performed for or provided to the patient. This article discusses situations where there have been questions from the provider community. [SE17023]
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.